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J Indian Soc Periodontol. 2012 Jan;16(1):84-8. doi: 10.4103/0972-124X.94611.

Clinical effect of miswak as an adjunct to tooth brushing on gingivitis.

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Department of Periodontology, JSS Dental College and Hospital, Mysore, Constituent, College of JSS University, Mysore, Karnataka, India.



The aim of the study was to clinically evaluate the effect of miswak as an adjunct to tooth brushing on plaque levels and gingival health in subjects diagnosed with mild to moderate chronic generalized marginal gingivitis in comparison with those of toothbrush users.


The study comprised of 30 systemically healthy subjects, aged 18-35 years diagnosed with mild to moderate gingivitis. The study was designed as a randomized, single-blind, parallel-armed study. Subjects were randomly divided into three groups. Group A (toothbrush users), group B (toothbrush and miswak users), and group C (miswak users). Subjects were advised to use toothbrush, miswak, or both, three times daily depending on their respective allocations. Gingival index according to Loe and Silness, Plaque index, according to Turesky modified Quigley-Hein plaque index, and the digital photographs of the total labial surfaces of the teeth were taken for image analysis. Recording of data were done at baseline, 2(nd), 4(th), 6(th), and 8(th) week time intervals. Obtained data were analyzed using repeated measure ANOVA and student t test (independent samples).


Group B showed statistically significant (P<0.0001) decrease in plaque score and gingival score compared to group A and group C, respectively, from 2(nd) to 8(th) week, whereas no statistical significant difference was found in plaque score, when group A was compared with group C (P>0.05) from 2(nd) to 4(th) week. Further at the 6(th) and 8(th) week, there was significant difference (P<0.05) in plaque score between group A and group C. The difference in gingival score was not significant (P<0.05), when group A was compared with group C on all the indicated time intervals.


Results showed significant improvement in plaque score and gingival health when miswak was used as an adjunct to tooth brushing.


Gingivitis; image analysis; miswak; plaque score; toothbrush

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